Lee YH, et al. – The outcomes and prognostic factors associated with palliative external beam radiotherapy (EBRT), administered to patients with advanced gastric cancer, were gauged. For treating tumor bleeding in advanced gastric cancer, recommended regimen was an effective method. Moreover, it did not induce severe toxicity.

Methods

• Expert examined forty-two patients with bleeding gastric tumors that received EBRT for palliation.
• The palliation of tumor bleeding appraised the response to EBRT.
• They classified patients as either responders, or non-responders to EBRT.
• They investigated the prognostic utility of clinical and dosimetric variables in a multivariate logistic regression model.
• With receiver operating characteristic analysis, the optimal dose cutoff to classify the two groups was determined

Results

• In 29 patients (69.0%), the palliation of gastric tumor bleeding after EBRT was achieved.
• Furthermore, the time to resolve tumor bleeding ranged from 1 to 84 days (median, 15 days).
• They indicated that the median duration of palliation was 14.9 weeks.
• With the difference being significant (p < 0.001), the median EBRT dose was 40 Gy in responders vs. 21 Gy in non-responders.
• As compared to the BED10 for non-responders (median 48 Gy vs. 26.4 Gy, p < 0.001), the biologically effective dose (using α/β= 10, BED10) for responders was significantly higher.
• The optimal cut off value to separate the two groups was 36 Gy (p < 0.001).
• A better EBRT response was exhibited by the absence of distant metastasis and the use of concurrent chemotherapy generally (p = 0.079 and p = 0.079, respectively).
• BED10 ≥ 36 Gy was the most significant factor associated with EBRT response (p = 0.001), in the multivariate analysis.
• Median 12.6 weeks and 14.9 weeks were overall survival (OS) and re-bleeding-free survival.
• They revealed superior OS in the responders to EBRT (16.6 vs. 5.1 months, p < 0.001).
• They did not observe neither acute nor chronic toxicities of grade 3 or higher.